Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years
Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years
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DOI：
10.1097/01.sla.0000217592.04061.d5
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发表时间：
2006-11-01
影响因子：
9
通讯作者：
MacLean, Lloyd D.
中科院分区：
文献类型：
--
作者：
Christou, Nicolas V.;Look, Didier;MacLean, Lloyd D.
目的：为了完成一个长期的（>10年）对因严重肥胖而接受孤立性Roux-en-Y胃旁路术的患者进行随访。背景：在文献中没有报道胃旁路术患者随访超过10年的长期结果。方法：272例患者中有228例（83.8%）在术后平均11.4年（范围：4.7-14.9年）时记录了准确的体重。结果分别记录了长肢和短肢胃旁路术的个体基础，并与术后5年和>10年时BMI最低值和%多余体重减轻（%EWL）的结果进行了比较。有显著（P < 0.0001）病态肥胖组和正常肥胖组的BMI增加（BMI < 50 kg/m2）和超肥胖患者（BMI > 50 kg/m2）从最低点到5年和从5到10年。与病态肥胖患者相比，超级肥胖患者从时间零点开始体重下降更快，在大约2年达到最低体重后体重增加更快。长肢和短肢手术的结果没有差异。与5年时相比，10年时失败率显著增加，优秀结果显著减少。当所有患者随访至少10年时，病态肥胖患者的失败率为20.4%，超级肥胖患者的失败率为34.9%。结论：胃旁路术肢体长度不影响长期体重减轻。在胃旁路手术后达到最低体重后，患者体重持续显著增加。尽管体重增加，但长期死亡率仍然很低，为3.1%。
Objective: To complete a long-term (>10 years) follow-up of patients undergoing isolated roux-en-Y gastric bypass for severe obesity.Background: Long-term results of gastric bypass in patients followed for longer than 10 years is not reported in the literature.Methods: Accurate weights were recorded on 228 of 272 (83.8%) of patients at a mean of 11.4 years (range, 4.7-14.9 years) after surgery. Results were documented on an individual basis for both long- and short-limb gastric bypass and compared with results at the nadir BMI and % excess weight loss (%EWL) at 5 years and >10 years post surgery.Results: There was a significant (P < 0.0001) increase in BMI in both morbidly obese (BMI < 50 kg/m(2)) and super obese patients (BMI > 50 kg/m(2)) from the nadir to 5 years and from 5 to 10 years. The super obese lost more rapidly from time zero and gained more rapidly after reaching the lowest weight at approximately 2 years than the morbidly obese patients. There was no difference in results between the long- and short-limb operations. There was a significant increase in failures and decrease in excellent results at 10 years when compared with 5 years. The failure rate when all patients are followed for at least 10 years was 20.4% for morbidly obese patients and 34.9% for super obese patients.Conclusions: The gastric bypass limb length does not impact long-term weight loss. Significant weight gain occurs continuously in patients after reaching the nadir weight following gastric bypass. Despite this weight gain, the long-term mortality remains low at 3.1%.